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Adult smoking rate drops slightly to record low of 13.7% in 2018

The U.S. adult smoking rate slipped to another historic low — this time 13.7% for 2018 — though it remains the most commonly consumed tobacco product, the U.S. Centers for Disease Control and Prevention said Thursday.

The data comes in the CDC’s 53rd annual National Health Interview survey. It measures adults who smoke every day, some days or have ever smoked.

The rate reflects that about 35 million adult Americans still smoke cigarettes. The rate was 13.9% in 2017, 15.8% in 2016 and 15.1% in 2015.

The national adult smoking rate was 20.9% as recently as 2005 and 24.7% in 1997.

A historic low of 17.2% of North Carolina adults were considered as smokers in 2017, as well as 12.1% of youths, according to anti-tobacco advocates The Truth Initiative.

Altogether, 19.7% of U.S. adults consumed a tobacco product at least once in 2018. The other usage includes: cigars, cigarillos, or filtered little cigars at 3.9%; e-cigarettes at 3.2%; smokeless tobacco at 2.4%; and pipes, water pipes or hookahs at 1%.

“These new findings regarding the decline in cigarette smoking are very encouraging and should be celebrated,” said Dr. John Spangler, a professor of family medicine at Wake Forest Baptist Health.

“Nonetheless, they do not tell the whole story about all smoking or all tobacco use,” saying tobacco products such as cigars, cigarillos or little cigars “are just as unhealthy as cigarettes.”

“Many adults (18.8%) use two or more tobacco products,” Spangler said.

Spangler said that counties with the highest rates of smoking tend to be smaller and poorer, with higher populations of minorities and higher rates of infant mortality.

“Clearly, our state has more work to do,” Spangler said.

The slight increase in U.S. adult consumption of e-cigarettes from 2.8% in 2017 reflects the rise in use among young adults (ages 18 to 24), which went from 5.2% in 2017 to 7.6% in 2018.

“This marked decline in cigarette smoking is the achievement of a consistent and coordinated effort by the public health community and our many partners,” CDC Director Dr. Robert Redfield said in a statement.

“Yet, our work is far from over. The health benefits of quitting smoking are significant, and we are committed to educating Americans about the steps they can take to become tobacco-free.”

As has been the case in recent years with the annual adult and youth smoking rate reports, the key factors contributing to the decline depends on the anti-tobacco or anti-smoking perspective.

Anti-tobacco advocates cite the influence of “evidence-based strategies that have been implemented at the federal, state and local levels.”

The strategies include: tobacco tax increases; comprehensive smoke-free laws; well-funded tobacco prevention and cessation programs; mass media campaigns, health insurance coverage for tobacco cessation treatments; and laws raising the tobacco sale age to 21.

Dr. Brett Giroir, acting commissioner of the Food and Drug Administration, said the “sustained drop in adult smoking is encouraging as we work to reduce tobacco-related disease and death in the U.S. through science-driven policy, compliance and enforcement in addition to public education.”

“We remain dedicated to keeping pace with the evolving tobacco product landscape to ensure strong regulatory oversight in light of the increases in youth use of e-cigarette products in the U.S.”

In 2018, the N.C. General Assembly raised the amount of funds for tobacco prevention programs by $1 million over the 2017-19 budget years for a total of $2.8 million.

The additional funding is going toward “developing strategies to prevent the use of new and emerging tobacco products, including electronic cigarettes, by youth and people of childbearing age.”

An attempt to raise the e-cigarette excise tax rate to the level of traditional cigarettes cleared a House committee on Oct. 30, only for the language to be removed hours later in the House Rules and Operations committee.

Rep. Gale Adcock, D-Wake, said that while her amendment doesn’t address the national vaping illness crisis, “it is a good time for this bill to create a level playing field for electronic cigarettes and vaping products.”

The amendment would have used the net proceeds from the tax to help create the Tobacco Use Prevention Fund, beginning July 1. The fund would evaluate, track usage and make recommendations concerning “emerging tobacco products ... especially among youth and people of childbearing age.”

“This establishes a permanent funding stream for tobacco use prevention with an emphasis on youth and on vaping,” Adcock said.

Anti-smoking advocates point out that the CDC data releases continue to not examine the impact of e-cigs on smoking rates.

“In keeping with the government’s relentless attack on e-cigarettes, the welcome decline in smoking was not linked to National Institutes of Health survey data showing that higher proportions of current vapers are former smokers,” said Brad Rodu, a professor of medicine at the University of Louisville and an anti-smoking advocate.


Z-no-digital
Democrats invite Trump to testify in impeachment inquiry

WASHINGTON — Democratic House Speaker Nancy Pelosi invited President Donald Trump to testify in front of investigators in the House impeachment inquiry ahead of a week that will see several key witnesses appear publicly.

Pushing back against accusations from the president that the process has been stacked against him, Pelosi said Trump is welcome to appear or answer questions in writing, if he chooses.

“If he has information that is exculpatory, that means ex, taking away, culpable, blame, then we look forward to seeing it,” she said in an interview that aired Sunday on CBS’s “Face the Nation.” Trump “could come right before the committee and talk, speak all the truth that he wants if he wants,” she said.

Senate Democratic leader Chuck Schumer echoed that suggestion.

“If Donald Trump doesn’t agree with what he’s hearing, doesn’t like what he’s hearing, he shouldn’t tweet. He should come to the committee and testify under oath. And he should allow all those around him to come to the committee and testify under oath,” Schumer told reporters. He said the White House’s insistence on blocking witnesses from cooperating begs the question: “What is he hiding?”

The comments come as the House Intelligence Committee prepares for a second week of public hearings as part of its inquiry, including with the man who is arguably the most important witness. Gordon Sondland, Trump’s ambassador to the European Union, is among the only people interviewed to date who had direct conversations with the president about the situation because the White House has blocked others from cooperating with what they dismiss as a sham investigation. And testimony suggests he was intimately involved in discussions that are at the heart of the investigation into whether Trump held up U.S. military aid to Ukraine to try to pressure the county’s president to announce an investigation into Democrats, including former Vice President Joe Biden, a leading 2020 candidate, and his son, Hunter.

Multiple witnesses overheard a phone call in which Trump and Sondland reportedly discussed efforts to push for the investigations. In private testimony to impeachment investigators made public Saturday, Tim Morrison, a former National Security Council aide and longtime Republican defense hawk, said Sondland told him he was discussing Ukraine matters directly with Trump.

Morrison said Sondland and Trump had spoken approximately five times between July 15 and Sept. 11 — the weeks that $391 million in U.S. assistance was withheld from Ukraine before it was released.

And he recounted that Sondland told a top Ukrainian official in a meeting that the vital U.S. military assistance might be freed up if the country’s top prosecutor “would go to the mike and announce that he was opening the Burisma investigation.” Burisma is the gas company that hired Hunter Biden.

Morrison’s testimony contradicted much of what Sondland told congressional investigators during his own closed-door deposition, which the ambassador later amended.

Trump has said he has no recollection of the overheard call and has suggested he barely knew Sondland, a wealthy donor to his 2016 campaign. But Democrats are hoping he sheds new light on the discussions.

“I’m not going to try to prejudge his testimony,” Rep. Jim Himes, D-Conn., said on “Fox News Sunday.” But he suggested, “it was not lost on Ambassador Sondland what happened to the president’s close associate Roger Stone for lying to Congress, to Michael Cohen for lying to Congress. My guess is that Ambassador Sondland is going to do his level best to tell the truth, because otherwise he may have a very unpleasant legal future in front of him.”

The committee will also interview a long list of others.

On Tuesday, they’ll hear from Morrison along with Jennifer Williams, an aide to Vice President Mike Pence, Alexander Vindman, the director for European affairs at the National Security Council, and Kurt Volker, the former U.S. special envoy to Ukraine.

On Wednesday the committee will hear from Sondland in addition to Laura Cooper, a deputy assistant secretary of defense, and David Hale, a State Department official. And on Thursday, Fiona Hill, a former top NSC staffer for Europe and Russia, will appear.

Trump, meanwhile, continued to tweet and retweet a steady stream of commentary from supporters as he bashed “The Crazed, Do Nothing Democrats” for “turning Impeachment into a routine partisan weapon.”

“That is very bad for our Country, and not what the Founders had in mind!!!!” he wrote.

He also tweeted a doctored video exchange between Rep. Adam Schiff, the Democratic chairman of the Intelligence Committee, and Republican Rep. Jim Jordan, in which Schiff said he did not know the identity of the whistleblower whose complaint triggered the inquiry. The clip has been altered to show Schiff wearing a referee’s uniform and loudly blowing a whistle.

In her CBS interview, Pelosi vowed to protect the whistleblower, whom Trump has said should be forced to come forward despite longstanding whistleblower protections.

“I will make sure he does not intimidate the whistleblower,” Pelosi said.

Trump has been under fire for his treatment of one of the witnesses, the former ambassador to Ukraine, Marie Yovanovitch, whom Trump criticized by tweet as she was testifying last week.

That attack prompted accusations of witness intimidation from Democrats and even some criticism from Republicans, who have been largely united in their defense of Trump

“I think, along with most people, I find the president’s tweet generally unfortunate,” said Ohio Republican Rep. Mike Turner on CNN’s “State of the Union.”

Still, he insisted that tweets were “certainly not impeachable and it’s certainly not criminal. And it’s certainly not witness intimidation,” even if Yovanovitch said she felt intimidated by the attacks.

Rep. Chris Stewart, R-Utah, said Trump “communicates in ways that sometimes I wouldn’t,” but dismissed the significance of the attacks.

“If your basis for impeachment is going to include a tweet, that shows how weak the evidence for that impeachment is,” he said on ABC’s “This Week.”

And the backlash didn’t stop Trump from lashing out at yet another witness, this time Pence aide Williams. He directed her in a Sunday tweet to “meet with the other Never Trumpers, who I don’t know & mostly never even heard of, & work out a better presidential attack!”


Local
An inmate died in the Forsyth County Jail. Now a lawsuit over the death goes to trial next year.

A trial is set for December 2020 in a federal lawsuit that accuses Forsyth County Jail’s medical provider of ignoring a Winston-Salem man’s high-blood pressure, leading to his death nine days after he was incarcerated.

Stephen Antwan Patterson, 40, was one of two men to die at the jail in May of 2017. Deshawn Lamont Coley also died that month, and the two men’s deaths sparked local protests and increased scrutiny of the jail’s medical provider, Correct Care Solutions Inc., which is now known as Wellpath. Wellpath emerged after Correct Care Solutions combined with another company.

According to a court document filed last month, the trial is scheduled to start Dec. 7, 2020, in the federal courthouse in Winston-Salem. It will be a jury trial. The document does not indicate how long the trial might last. A settlement conference will have to be set at least two weeks before the trial, the document said.

Attorneys for Zyrale Jeter, Patterson’s oldest son and the executor of his father’s estate, filed the lawsuit initially in Forsyth Superior Court before transferring it to U.S. District Court of the Middle District of North Carolina, which includes Forsyth. The cases of both Patterson and Coley were featured in a story in The Atlantic magazine dealing with how Wellpath has become the biggest provider of jail health care.

The lawsuit alleges that Patterson, who was being held on a charge of failing to pay child support, went into the Forsyth County Jail on May 18, 2017, where medical personnel screened him. His blood pressure was 210/140. According to the lawsuit, Patterson’s blood pressure was dangerously high and could “result in death, serious injury, target end organ damage and/or neurological changes manifesting as altered mental state, confusion and anxiety.”

The lawsuit said Patterson’s blood pressure was an urgent condition that requires immediate medical attention. According to the lawsuit, Patterson told medical personnel that he was taking a pill containing two medications to control his blood pressure but he had not taken it for six months because he didn’t have a medical provider.

According to the lawsuit, Correct Care officials checked his blood pressure once more, when it measured 204/138. After that, his blood pressure was never checked again, the lawsuit alleges. That was despite having Dr. Alan Rhoades, the jail’s medical director, order that Patterson’s blood pressure be checked every day, the lawsuit said.

“Neither Rhoades nor any other medically trained care provider employed by CCS ever evaluated or monitored Decedent again, ever took his blood pressure again, ever performed simple diagnostic testing such as blood work, EKG or urinalysis, or ever even bothered to ask Decedent how he was feeling,” the lawsuit said.

Between May 20 and May 24, 2017, no one documented his condition, the lawsuit alleges.

Patterson died on May 26, 2017, of probable cardiac dysrhythmia, or irregular heartbeat, due to hypertensive cardiovascular diseases, according to his autopsy report. Patterson had an enlarged heart and a thickened left ventricle, meaning the ventricle had to work harder to pump blood through the rest of his body, the autopsy said.

Correct Care officials have denied all the allegations, saying that Patterson was given three medications the day he entered the jail and that a nurse practitioner wrote an order for amlodipine and lisinopril. They also argue that Patterson “failed to exercise reasonable care for his health and safety.” An attorney for the medical provider, Jennifer Milak, said Patterson refused to take his medication on the day he died.

Correct Care Solutions has been sued several times over deaths of people at the Forsyth County Jail. Lawsuits were filed over the 2013 death of Dino Vann Nixon and the 2014 death of Jennifer Eileen McCormack Shuler. Both lawsuits were settled.

Earlier this year, the mother of Deshawn Coley, filed a lawsuit in Forsyth Superior Court against Correct Care Solutions, alleging that medical personnel failed to treat her son’s asthma. That lawsuit is pending.